I have a space between my 2 front teeth, however one of my front teeth is a crown and the other front tooth is part of a bridge. Can the gap between my front teeth be closed with Lumineers or any other procedure or would I have to get a new bridge and crown, possibly all in one structure to close the gap?
– Laura from Nevada

Laura,
Your question prompts me to ask a question of my own: Why did the dentist who made the crown and/or the bridge leave a gap between your front teeth? The easy way to fix this would have been to make them correctly in the first place.

At this point, yes, you pretty much need to have probably both of them re-made—depending on how big the gap is. Both front teeth need to be the same size—you don’t want to close the gap from just one side by making one side larger.

A Micro-Etcher

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But there is a procedure you might want to try before doing that. There are ways to bond composite to porcelain, and you could start with trying that—treating this as a dental bonding case. If the dentist has what is called a micro-etcher, which is a small sand-blasting handpiece, he or she could micro-etch the porcelain surfaces next to the gap. This would be followed by etching with a hydrofluoric acid gel and then priming the surface with a silane coupling agent. A bonding resin would then be applied followed by composite bonding material to match the shade of the crown and the bridge. The composite would be shaped and polished. In theory, this should work. However, my experience with bonding to porcelain was that after a few months, we would see staining along the margin between the composite and the porcelain. But it could be worth a try to try to avoid the expense of a complete re-do of your front teeth.
I would think it goes without saying that you need an expert cosmetic dentist to do this, such as we recommend on this website.

The company that makes Lumineers, a few years ago, tried to promote the idea of bonding Lumineers over the top of porcelain crowns, but I strongly discourage that. You would get the same risk of staining at the margins, and would spend the same amount of money as you would spend just re-doing the case completely. Click the link to read more about the problems with that approach.

– Dr. Hall

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About David A. Hall

Dr. David Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does complete Internet marketing for dentists.

Dr Hall,
I recently had my six front teeth, from canine to canine, crowned. Doing this it closed a large gap between my two front teeth. Now I can’t speak clearly and because of the closure and the stress of trying to learn how to speak again my jaw and neck hurt all the time. Also, my mouth stays dry and my lips are numb what could this be caused by?? Also is it possible to get the space put back between the two new crowns on my front teeth?? Your advice would be appreciated.
– Paul from Georgia

Paul,
This sounds like a serious problem that needs to be addressed.
I am pretty confident your troubles have nothing to do with closing the gap between your two front teeth, but are because of other problems with the crowns. I closed many such gaps in my practice and never had any adverse feedback like you are giving me—no speech issues, pain, or dry mouth. It sounds to me that your dentist opened your bite too far.
It could be that your crowns are too thick and/or too long. This could cause a problem called lip incompetence which is the failure of the lips to close naturally, without effort when your teeth bite together. If your bite is correct, when you put your teeth together, your lips should naturally fall into place and be closed without your having to think about it. Your dry mouth and the numbness in your lips suggest to me that you may have this lip incompetence.
Also, if your crowns are too thick, they could throw off your bite leading to pain in your jaw and neck, besides causing speech problems.

Both the pain and the dry mouth are serious problems. The pain issue is obvious. The dry mouth less so but is just as important because it can lead to rampant tooth decay. The washing and buffering action of your saliva, plus the antibodies it contains are critical in fighting tooth decay. Don’t let this go on.

You really need a second opinion. I’m suspecting that your dentist got in over his or her head in doing this many crowns simultaneously on you. That’s my guess. I’d go to one of our recommended cosmetic dentists to evaluate the result and see what needs to be done to fix it.
– Dr. Hall

Do you have a comment or a question or anything else to add? We’d love to hear from you. Enter your comment below.

About David A. Hall

Dr. David Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does complete Internet marketing for dentists.

I had been saying that the before-and-after photographs on the home page were of different patients – that the “before” photograph was a different person than the “after” photograph. I was quite surprised when Rebecca told me that the pictures were of her, but that she had had other dental work in between the photographs. Either way, this is a misrepresentation. The work must be porcelain veneers or porcelain crowns, which would be one appropriate choice for fixing this tooth gap. The “after” photo does not represent the results of using these Teeth Perfect bands.

Here is the comment from her e-mail: “It is the same individual but they had additional work done to their teeth. How do I know? Because they are my teeth!”

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About David A. Hall

Dr. David Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does complete Internet marketing for dentists.